Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
0255 OCEAN STREET
i f �� �� �.��: ��y � �= ,* _,.. _ _-- _ _ AO lo t, / `I { IA ti 7 1 'Wit 3 1 _ t a J r r. jyi C y � V YG �S:✓ i y^� A / '7h11-2 Town of Barnstable *Permit# js-/?. Regulatory Services �e rvem 6 months from issue date s AM Richard V.Scab,Director ` Building Division 200 Main Street,Hyannis,MA 02601 ✓(/ ' www.town.bamstable.ma.us 14, Office: 508-862-4038 s08-790-62130 EXPRESS PERMIT APPLICATION - RESIDENTIALa°� . r i --Press Imprint Map/parcel Number �j c n c �0 ( of Valid without Red X Property Address C '�, esidential Value of Work$ Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address �' Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) ( Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance _ C�h�ec °ne: L"1 1 am a sole proprietor x° ❑ I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Request eck box) VkRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows_" #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is rpoired. SIGNATURE: F QAWPMESWORMSUilding permit forms\EXPRESS.doc 01/25/17 " 4 ' Cor�am�ea�t�jf�tr�sdls • Orser GOTPedwaftaru SBD�Ya�gitor�,�eet . ' tcrviazr�r�gavfd4a Wurk-ern° CuVensiUmIu ceAff w&' Bwlders/Comractmrs/Elec i 'a„sd%m3hers IUfmrm3i,V1rM PlenePrint Norm Ad&c= -�Ji e v -gk' / Fire you on emp1Uer9 theAthe apprapriafe bay ' Type of project(re gmimd): L❑ I am a 1 wift 4. ❑I am a genaml connector andI ❑ yew(andfor part- ime * ae luradthe sub-ca�.ct= 6. New coos ion dd Remmg 2. I am a sole orpartaw- Tined oath a sclzed s�see€. I- El ° sly and have ao eplogem . These sub-caafraclnrs ha:v. a 8..Q Demli&a wording forme in any sty. emFloyew andhave wadmare 9. ❑Building addifior! PTO ' comp.iasu ace comp_imranclml 5. ❑ We are a=porafioa and its 10-❑Elec i rgnirs or addidim 3-❑ I ama home=m.�er doing at>wo&z afficeas have exercised thins I❑Fh=biagrepairs ar ad&fiws. mysidf o wark of L oaf per MCC 7 rued-j es'1 F- C.M§I(•4k andwe hwe non employm---[Na 13_❑o ier ��yspy&cz��sr�hed3�wc�ltffistaisaSIlo�tl�sec�aabe�vshanm.�Biea•wo3tex�c®peasatinupnlieg�ua . # stem snit�tins affidzeg m 8eey�3oing slE�rca3c audtBmhiie o-�sidecrat�tas�st�t a newaffid�t iadi�g sacTi �Ca ctbs$wtebect$�s6mc�Kattsd�m2ddiri=d shad dMcingtha--ofthe ssxadFtdanLefmarnaM seeaYitiesbive mvbyees.Ifthem&-co-afiradoesIrm m 4Yyae%they mn y=Ade dwk '—ap.pormy-mg me I am art empbasr Stet ispr4vhHq,markets'campematian fiz=ranDefoi rsy empkwes $dlow is the policy cnrd job zYr informcriiam IasuzanseCotsgaayl�e: • 'Pfl-ficy 4 or Self-im.Iio.¢ aDafe: ' lob Eta Addresw C 15tafef : Af#ach a copy of the warmers'compensaflonpolicydechratian page(zh,%wi g the policy number ad expiration daite). Fail fn secure coverage as required nudes Section 25A of M(H a M can lead to the imposition,of crimiaai penalties of a fine up to•$UOD 4Q andfor one-yearinqxism=4 as well as cif peua?lies n the firm of a STOP WORK ORDER and a fine of up to$250-00 a dap agatast&e,violator. Be advised that a copy of this zbdemed nzybe farFrarded to the Office of INVWE9afi=ofte D4 for finmaxt-mveeage mom. Ida hffz&y cerfyy tles rff pay th&a s hbrmoutfauprosi�d abm is ari,d c mrect 5 �.natarep Dam Orkhd Ass wffjy Da not wft in&h;=a,€rt be coaup&a by cad?wrtacrn rn,j x&L City or Tam= Permftmicewe:g Leg AmBrorfty(ch-de one): 1.B=rd of ffzd& 1%&frog Depart 3.Oly!£owa Clerk 4.Electrical Fir -5.plumbing Fasgeefnr &vRher COM"ct Person: now __ 6 jfimmcb=eft Gebaal Laws car M rupnes all euTIoymM to Xm&wD'kme campmsEtim for fLcir=plops. this sue,an CUT&7W is defined as¢-=%ypesonin.flia sexvicx ofanaffim mcler any cfbnr., cspsess ar iCMPlie4'Dial Cr wsiftE An�Ioy�is de<fined"as�u i'ndxvidu��pain .assochdicm,�P°�m or otma IegaI cut ar�ivQo or mine of$��=ag wed is a3aint .aadmclndmg the legal=pes=bdves of a deceased employrs,or the or Df an bXRi ual,Pnt=MEiP•aasociattDn or offiW Iegal=Jity,°playing empmym- HoWever fiia o ofactweIImgh=whavmgnDt3n ethemtbrecapadm=ftmdwhoresidmst =ir6csflieo affbe- dweTTmg bonne of mother wbn eUzplays pexs®s tD da mamt =rq cm*act m or repak uric as such dweIIing LDuse or an.f�gtoUnds or b Uft qpp fherein inl1no'tb=m=of sacdi employmentbe dremedto be an enzployer-" Icl3apirr ISZ,§2$C(6)also s5des fhat-every SF f ar IDcal Iiceasmg agr�ncyskallwMhold fhe i==ca �P-or ' rcae.�eaI of a ficease ar permit to oper�c a>}Usiaess or�construct btU1d"iags iu fjie commonwealtdt for asrp . applicantw•ho has notpraduced acceptable evi&mm of cdm.PUa=:ewzHi the anmca4exagerequir -n i MM chapter I52,p5(M stairs fiTeffiez the nor gay ofxb poIif=l snbd Tmms shaIl enter into any frsfhep ofpnbhr workvbI acceptable Mdm=of cilia„ f-w&the insmrnc6.. reqMcmenfs of tbis rhapfM havo lie=p=C=ted to the eortadmg.M iiouty_" I Applicants Pl Ise fll Dirt fhe w�'�Peasa dDn affidavit completmIN if by g b0xcs[ice apply f°y°�s�0n and, ne�sazY, Ply snb- r s)mm�e{s), add=ess(es)�p�nemmObe�(s)alon gwitiifheir s)of ms�_ j nbility Companies(LLg arla=t�&Liabf7ity Pinta=gs(LLP)'•Wino =3•Pb'Y=of Cr fhaniiie mesmb=or pa.bac:m., arenot fn cany =33P—saiiOnmsm� IfanLLC crLTP doeshave � a o is Be advisedthattiiis a$day�maybe snto theDegaitmeat of IndnsiriILl A 8cl for co�mefim of u•�sm�coveaage ATso Ire sin a is sign and dafe the of daYit. Zba affidx4it should be to$e c$y or tDwn tbet fhe BPplic s im f 0i file pew or license is besng x�gaeslnd,not fb a De parfineaf of Ti�rirrcfiriai�Lcidenfs- gOEMyauLILY°anyquestms fiielaworifyou HIM xquiedtoobf�mworlc=' ' oainpcn saE pDRcy,please can f c,De pmtnenf at fhe n.=bez list belnvr_ Self-ftozed con[panics shoUId e r their self-��license�an ffie Iine: City Dr Town Of ad2js Please:ba sm-m fiat the davit is c=3plefn andplidcd Iep-bly. The Department Las pmTided a spa=at ff=botb3m ofthe a$ida�for yDnto fill otrtinthe-Yeutthe Office o� *stiga has to co�actyo¢reg'acdmgii�e ag H=t be Used as a reface numbcr-In.addai�,an aPPHcant Please be sere to fM nfl a p�id'llicensc w�h�ch� wx� need.�Y sabmit=affidavit mdi�g C=tMt that must sabmit�le p�,nTtlT,=n=app any&=yam. policy mfox=oatioa(if n=ssaiy)and midrr=Tob Site Addm&-fhe apphcamt should write¢sII IDcatians in (�Y or town)_"A copy of ihc-effidavitfiiathas been officiatiy wed armadoedbyfize city ortovamay be provided fo� appHcant as prooffhat a valid affidavit is on file fir f�nre'pc 43 or Hce�srs. Anew bU ,a roust b _"a H year.Whe e ahome owner or cifizr�is oM�ing aTmense ar pr tnotrelatedfo any a dog license orpmmit too bmn leaves ct�---)said pmson is NOT rujaked to�le#e his affidayst The Office of Ind waaah�to thank you in advice for your coDpe an and sboUIdyou have any 4u �, please do not llMi O to&C a caIL 'Ihe Departm=fs address,trlephone and;ffic raaaber. na *of Bastou.MA W I r ' T(�L:1461 t�-7 M mt 406 w 1-977-TiLA M Fag 617-727 7749 Revised¢24-0 T A Town of Barnstable Regulatory Services DIUM - Richard V. • Directo r •�, sue, Building Division. Paul Roma,130ding Commissioner 200 Mau Sheet,Hyannis,MA 02601 www.town.barnstablema.us Office: 508-862-403 8 Fax: 508-790-6230 Property Owner Must Complete and Sign This Section If Using A Builder , G✓Sa2s Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building petinit apphcation for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before- fence is installed and all final inspections are performed and accepted: 4nature.of Own tare of Applicant Print Name rmt Name Date Q:FoxMs:owNER PERMIssI0MMI S Town of Barnstable Regulatory Services h p1F Richard V.ScaIi,Director Building Division It sumn&Bm t .Paul Roma,Building Commissioner i6j �� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street village "HOMEOWNER": name home phone# work phone# CURRENT MAILING ADDRESS: city/town state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER," k _,:;� Persons who owns a parcel of land on which he/she resides or intends to reside,6 t`whucllrth�re`is,or is°i&n'd1d&tb be;a one or two- ( ) family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner..Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulattois` ','"w -tea�,>s< .4, - , L � 4 The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedures and requirements and that he/she will comply with said procedures and requirements. Signature of Homeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permifis required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors);provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assu"ming.fk( ib ties o€wa sup.erVlsor (see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Secfion 2.�5) 'Iahis lack of'awarenbss�ften results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. ,}^ To ensure that the homeowner is fully aware of his/her responsibilities,many communities requir,4;1,as pit of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. Q :\WPFa ES\FORMS\building permit fonns\EXPRESS.doe 0620/16 — �e�pwrrurrca�acuea`G�i o�C�caaaacluraeG�i Office of Consumer Affairs&Business Regulation HOME IMPROVEMENT CONTRACTOR Regbefore' ration the xpirat valid oon date.individual found return to: TYPE:Individual Office of Consumer Affairs and Business Regulation —=R a stration Expiration 10 Park Plaza-Suite 5170 —7 03/22/2019 Boston,MA 116 SCOTT QUILTEFU—�"'-A- ! I SCOTT QUILTER i 247 Strawberry HIL Fed �� Centerville,MA 0263z=- > Undersecretary Not valid without signature ` 7 Construction.Supervisor Restricted to: nr than 35,0001culbc feet(s of 991scubic met which rs)ofontain enclosed space. Failure to possess a current edition of the Massachusetts . State Building Code is cause for revocation of this license. DPS Licensing information visVt it: YVWWMASS.GOVIDPS Massachusetts Department of Public Safety Board of Building Regulations and Standards License: CS-078000 Construction Supervisor SCOTT H QUILTER PO BOX 727 WEST HYANNISPORT MA 02672 ` ^^� Expiration: Commissioner 02/03/2018 I r r �IKE r� Town of Barnstable *Permit# Eapires 6 months from issue date Regulatory Services Fee - BARKSPABL.E. I 9 M039.ASS, �+ Richard V.Scali,Director �r„• q'I ED MA'1& Building Division Tom Pe g Perry,CBO,Building Commissions 200 Main Street,Hyannis, 601 CEP 2 6 2016 www.townbarnstable.i�atl��� OF Office: 508-862-4038 BARiVST 0$-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONL Map/parcel Number Not Valid without Red X-Press rmprLw 1 �Q Property Address 255 Dar'A,v `sT, "-qA-r X)15, �I©260 f [Residential Value of Work$ g'10� Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address mF_Lis S A ..0 es i -s .P,-taPY_F OMPQ Qz(AUVIS 9Y319 ©aW i Contractors Name Au t—LP LuwF-y Telephone Number r{ (206-35&9 Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance Check one: U t am a sole proprietor ❑ t am the Homeowner ❑ l have Worker's Compensation Insurance Insurance Company Name Workman's Comp. Policy# Copy of insurance Compliance Certificate must accompany each permit. Permit Request(check box) ❑ Re-roof(burricane nailed)(stripping old shingles) All construction debris will be taken to jRe-side e-roof(hurricane nailed)(not stripping. Going over existing layers of roof) f 2 ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. 'Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner sign Property Owner'Letter of Permission. A copy of the me mprovement Contractors License&Construction Supervisors License is reonred. SIGNATURE: C:iUserslDecolliklAppDat,.tll.,ncalkMicrosofttWindowsVrempomry Internet FileslContent.0u1iookl2PI0I DME\PRESS.doc Revised 040215 Dream Horne Improvement LLC. 60 Franklin Ave, Hyannis, MA, 02601 DREAm Home Email:iohn.dreamhillc anmail.com 508-332-8119 John Collinson Project Manager Improvement LLC. 774-208-3589 Alexey LebedevOwner/Contractor www.dreamhomeim rovement.com H I C#: 176777 CS#: CS-108208 Contract DATE: 8 29 16 PHONE: 817-395-3669 NAME: Melissa Anestis EMAIL: melissaamafl@gmail.com MAIL ADDRESS: 255 Ocean St. Hyannis, Ma. JOB ADDRESS: 255 Ocean St Hyannis, Ma Dream Home Improvement hereby proposes to perform the following services in a neat, professional like manner in accordance with the manufacturer's specifications and local building code. Supplv and install — White cedar shingles. Remove all white cedar shingles from house. Install Tyvek vapor barrier to entire house. Install new R&R squared and butted clear white cedar shingles to entire house. First floor only. All debris will be removed from site Will have to get electrician to reconnect meter box(350$included in price). Eastern White Cedar Shingles (EWCS) has a 50 year warranty against wood decay, 15"year warranty on two coats of solid stain and nothing can match the classic warmth and beauty of re-squared and re- All labor,materials,disposal and permit fees are included in a price.All additional extra work will be charged 60$/h plus materials to butted E Total cost of lob $9,100.00 Deposit $3,000.00 Due upon start $3,000.00 Due upon completion $3.100.00 Make All Checks payable to "'Alexey Lebedev"' Compliance with Laws: Contractor agrees that it is properly licensed and insured under Massachusetts General Laws Chapter 142A and that it will perform the services contracted for herein in compliance with applicable building codes, laws, statutes and ordinances. Parties' Understanding of This Agreement: by signing this agreement,the undersigned Parties acknowledge they have had the opportunity to ask any questions concerning its terms; have read,understand and agree that its terms are fair and reasonable; and agree to be bound by the terms in their entirety. This agreement is effective as of the date it is executed by all the undersigned. Contractor` Customer Date sib ened All labor,materials,disposal and permit fees are included in a price.All additional extra work will be charged 60$/h plus materials a.. Massachusetts-Department of Public Safety `✓ Board of Building Regulations and Standards Construction Supersisor License: CS-108208 O ALEXEY LEBEDEV 60 FRANKLIN AVENUE Hyannis MA 02601 " >,f k t , ""'' Expiration Commissioner 11/27/2018 L 21 10 _= Office of Consumer Affairs and Business Regulation. -_ 1O.Park Plaza - Suite 5170 Boston, Massachusetts 02116 Home Improvement Contractor Registration - - Registration: 176777 Type: LLC •3i 'r'i l :` Expiration: 9/25/2017 Tr# 270447 DREAM HOME IMPROVEMENT LLC'!' ALEXEY LEBEDEV 60 FRANKLIN AVE. _ fi ��r r •'1 HYANNIS, MA 02601 -�, -7 :r, 4 ----- - x "' Update Address and return card.Mark reason for change. SCA 1 Co 20M-05/11 ; 1 Address Renewal [, Employment Lost Card �ln,�co->rrrrrancuet�/l/o��T�zwarcc�ic�r.-ll3 Office of Consumer Affairs X Business Regulation License or registration valid for individul use only 19HOME IMPROVEMENT CONTRACTOR before the expiration date. If found return to: - :Registration: ,`.176777 Type: Office of Consumer Affairs and Business Regulation Expiration 9/25%2017 LLC 10 Park Plaza-Suite 5170 . Boston.MA 02116 DREAM HOME IMPROVEMENT LLC' ALEXEY LEBEDEV .} ' 60 FRANKLIN AVE. :�.._crw•.-*---- HYANNIS,MA 02601 Undersecretary Not valid without signature r / 7 ® 73/14/2016 E(MM/DDNYYY) AC®R� CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT AshleyPaiva NAME: Southeastern Insurance Agency, Inc. PHONE (508)997-6061 F� No:(508)990-2731 A/C N Ext 439 State Rd. E-MAIL ADDRESS: p m a aiva@southeasternins.co P.O. BOX 79398 INSURER(S)AFFORDING COVERAGE NAIC# North Dartmouth MA 02747 INSURER AArbella Mutual Ins Co 17000 INSURED INSURER B AEIC Dream Home Improvements LLC INSURER C: 60 Franklin Ave INSURER D: INSURER E: Hyannis MA 02601 INSURER F: COVERAGES CERTIFICATE NUMBER:2016 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL UBR POLICY EFF POLICY EXP LIMITS LTR POLICY NUMBER MM/DDNYYY MM/DDNYYY X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A CLAIMS-MADE ❑R OCCUR DAMAGE TO RENTED 100,000 PREMISES Ea occurrence $ 9520053178 3/8/2016 3/8/2017 MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY PRO ❑ LOC PRODUCTS-COMP/OP AGG $ 2,000,000 JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS Per accident UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE I I ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBER EXCLUDED? N/A B (Mandatory in NH) WCC50050156792016A 3/8/2016 3/8/2017 E.L.DISEASE-EA EMPLOYE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE display only THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Ashley Paiva/AMP ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014101) The ACORD name and logo are registered marks of ACORD INS025r91"114mi The Commonwealth of Massachusetts Department of IndustrialAccidents d 1 Congress Street, Suite 100 Boston,MA 02114-2017 www mass.gov/dia NVorkers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers. TO BE FILED WITH THE PERMITTING AUTHORITY. Applicant Information Please Print Lelsibly Name (Business/Organization/Individual):Alexey Lebedev/Dream Home Improvement LLC Address:60 Franklin ave City/State/Zip: Hyannis, MA, 02601 Phone #:774-208-3589 Are you an employer?Check the appropriate box: Type of project(required): 1.n yam a employer with employees(full and/or part-time).* 7. ❑New construction 2.P 1 am a sole proprietor or partnership and have no employees working for me in 8. ❑ Remodeling any capacity.[No workers'comp.insurance required.] 9. El Demolition 3.❑I am a homeowner doing all work myself.[No workers'comp.insurance required.]t ]0❑Building addition 4.❑I am a homeowner and will be hiring contractors to conduct all work on my property. 1 will ensure that all contractors either have workers'compensation insurance or are sole I LE]Electrical repairs or additions proprietors with no employees. 12.❑Plumbing repairs or additions 5.❑I am a general contractor and I have hired the sub-contractors listed on the attached sheet. 13.❑ p Roof repairs These sub-contractors have employees and have workers'comp.insurance.: 6.❑We are a corporation and its officers have exercised their right of exemption per MGL c. 14.❑Other 152,§1(4),and we have no employees.[No workers'comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. *Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information.. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under MGL c. 152, §25A is a criminal violation punishable by a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator.A copy oft ' statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify un er the pa ns a dpenalties ofperjury that the information provided above is true and correct. Signature: Date: 9196 1� Phone#: 774-20 -3 89 Official use only. Do not write in this area,to be completed by city or town official. City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r Town of Barnstable .*Permit#'Z01510 Expires 6 hs su � Regulatory Services Fee s • BMMSTABM • � 1 `�$ Richard V.Scali,Director ATFD SS, Building Division Tom Perry,CBO,Building CommissionerJUN 19 ?015 200 Main Street,Hyannis,MAjOi260I www.town.bamstable.ma.us U iV OF BA RNS T �I Office: 508-862-4038 Faxi-5--08-790-6230 EXPRESS PERMIT APPLICATION - RESIDENTIAL ONLY 3z,5 ti- 0 Not valid without Red X-Press Imprint Map/parcel Number �� Property Address gJ S OCEAN .57.o 0/ �/�/W/'Jr,��4 7Z0 [Residential Value of Work$ Q Minimum fee of$35.00 for work under$6000.00 Owner's Name&Address 01 OF Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) [ Workman's Compensation Insurance Check one: ❑ Lama sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company Name Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. Permit Requ (check box) EvRe-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to C ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) ❑ Re-side ❑ Replacement Windows/doors/sliders.U-Value (maximum.32)#of windows #of doors: ❑ Smoke/Carbon Monoxide detectors 4 floor plans marked with red S and inspections required. Separate Electrical&Fire Permits required. *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. 4 ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIGNATURE: Q:\WPFILES\FORMS\buildin ermit forms\EXPRESUcc Revised 040215 ��.�{� Fsrcm-ana�.t�..#�rr�a�if-l�rss�r�ar-cf�,., �cz�n - • • � Freon Pi.�e-�u���- ' Name. _ &44/5.5.4 ,�iit/,ES7i�5 o2S�r OAA �i� AN 49-riAl- aG= rm im ?Clm&ft T Of���. � 'L❑ I am a •ia • - 4' I ❑ I w=a sole grater orparfi z- 5icb.-A an the e3 sib 7- ❑ g ship=uihai*enaemployees Zhu have $ ❑Demoaba �me im my�g andha tvoFi�rs' 4_ addi£im [Na. `C MP-Msm== camp- I El 3. ❑ e are a t oad I0-0 Eletda1 ar addition s 3_.F-1,I am Tam&Diaz z vuA-- of =hie cmrcmea ffaesr 1LO =P�s ar�dih�s / Tf INo" a'camp_ right ofem=pirda per MC9- I�❑�ofrepaas �It},aadwehavea =FIGY- Ees-ING ` iE Ciir &:a �mast,�m fin s�aabr7asPs�acem ffiesc�'mu�ar� �di�Y this basmffit BEd c¢��;��,*,�shy�aa�ti�asmenf ffse�r-um�e�m3��he��,-�+,��SesE.� _S �b cos sIi-Pe r�la-w%&Pg�p—uide 8dr Svc e to-mg.pa g � '� 'P rFrrrtisgr i t€ror�rrrs'c tt rtgar f�{ffiy earginyess 3,4gw is�sprHu.1d}rrb�a A±UCh M copg of r o�peusa ga$�dac rsiion (s vtr3ng f )?° xt�uiher mina ds€e}: Fos re t� ser me s tage s xeTrired wades Secfmn;25A o€MM c ISM czn lead iu the imgosih=oI-rami al PCMTR of a: e m•fie fay of a STGF WORTS ORDER-and s EMc rr€mp to$250_00 a day again the viobstaL ge advL-zd lb�a ropy of this za'aybe im-vrardod to use Of Eiirr of lwzv �of the DIA fix finaiw=covmzge I rfa �,.Mrfyjg trader-ffreFaius auip rx ` ffi+ �u rxza#iou prams aFze�e r`s h�a cmd zAR-- Qftcidzma=� D,7 rterf tvri6rik ffur wwa,fa b&,=nWhtyriT by dty or tam afficur£ L Roaxd.u-€lIeaIf t 2.BuffiUng 3.CSfyffawa 0=k 4-EIerhic IEaspec#ur S.Pfmm&EmgEmzp=tar rx Cxhw CantntJ3exzun: � � � �al I.-vis I52 req�es aII9 to pde 'corn theIoycrs p�a�fa$cis au�F�Pr i&domed as¢---e�exy Pr�an>a�e vice of�nibet nn�i��-Y co�ss�of bite, e=p=ss or med, oral orb" An mproper-is def acd as van i vidgal,per,assD�cm,0 f* CZ of 1legal= ,or any tiro m mare i offe ETmgoing engaged in a3oint etm:pris�and in ee Iega rcp=cnt6-Y=of a deed e-mployq-or the z�ceaves car try of an indi dmiI,per,won Cr of=Iegal e�iiy.e�Ioying ripIopees E[Dwr Ver r r ogtner of aeffmgbnusehavingnDtmore> fhlee apartmrs ands resides 13ieaein,cgffie occupant ofthe dwtEmg hake of aaofberwho=nploys persons to do inEfitmailm,gonrLmc m,or repair tfork on sorh dwe1.m.o house " or on the grmaids gr bmldmg aggminnar¢film sh&R not bec snse of sarh empIDymmt be deemed to be an.employer." ISM r;b p 1.52, §25g6)also'sta is ar•local licensing agency shaII wrt3�hold�e issuance or renewal of a.ncmmse or permit to operate a bless or to court slat.hmldhV in,fhe commonwealth for any apgJ'tcant Who has.not piudgced acceptable e �of coTaphaace wif ,t�e itance coverage regim e3� AAff±,n, br IAM chapter 152,§25C(7)stars zTeffiem�e commonrea7thaor any`of ifrpolidcal svbc vislaRs shall eft into aay=±mr t for the prance of pnbfm workumoti acceptable evidence of cxirupliance with the;,,crsran ce req cuts of fbis chapter have been pees �d toauthority' Applicaats Please fill out- the waTheas'compensation affidavit comple fz I by checking fie boxes that apply to yc-ur sifnzt ion and,if nec=aty, supply sUb-contacbn 7(s)aame(s), addresses)mid phone mmibea(s)along with then=6Ecatr;:Cs).o ;,,.crrrance. 7�itud 7 iabz�y C°m.Pam�s(LLG�or Lim�dI.iab�y ParEnerships(LL.P)wino employees other than the . members or partners,are mtr xF±-md to cagy workers'compensation inem-s =- If an LLC or I.LP does have employes;a policy is requur� Bc advised fiat Phis affi.davitmay be submilted to'tbD Deparment of Industiial Acxmdents for confirmation ofm�rce Coverage Also he sure to sign and date the affidavit The affidavit should be ret=i--d to the city or iDvvn that the applicafim for the permit or license is being rrquesi�d,rot the DePMtM eaf of Industrial'Accidents. Shonld you.have any quesfi=reo r t' e? or 3f you�*>gred to obtain a Work-Is' eomp=sation policy;please call.the Department at the mmaber listed below. Self insared companies should eater thtir self-mete h.ceiise ntmml;rd on the sppropiiair,line, City or Town Officials Please be sure t�A tb.e affidavit is complete and pry Iegilily- '_hc,Depa tiacof provided a space ai ffie hot o f theffr at3av�t fir you in fill out is the eveat tlm OfficeoflnvmfigEtions has in confazt.yoII rega iing the applicant Please be snz a to f a.in the pcu itlliceose m-rmbcx which will be used as a reference nIImbar. In add=tioa�an sppliDaut that lust sabrnit mu tiiple p®hlhcrose applitatL=.m any given year,need only submit one affidavit iodic ng cwsent policy info ton(ifnecesmy)and under mob SE-, a the applicant should write'all locations in (city or town).-A copy of the affidavit tlaa±has been officially stamped or madced by the city or town may be provided;n the applicant as proof that a valid affidavit is on HID fDr fit=permits or licenses Anew affidavit must be filled.Olt each year_Where a home owner or ci iye is obiaiming a license or pannit not reIaixd to,any bossiness or comm exc ial Yentue Ci e,a dog licem r,or permit to bum Ieaves et.)said person is NOT mqukzd to complete this affidavit The Office of hives ins would hIm to ihmk you in advance ET your cooperation and should you have azty.qucsf ns; - please dD not�ecifnfP�give riS a call. - • The Depa tm=j s s _ ,Wephone and faxnnmbea:-- 'IIZa Camera th Ofl�as�achb • - . meat Of�rIaIA ��.. � . - � -• TeI..9 617-727-4 Q�±4.66 ur I-8-MAZE Rovi.--Di 4-24-07 �E F4 � A • RARN6'r"M ' 1639. ,m� Town of Barnstable Regulatory Services Richard V.Scali,Director Building Division Thomas Perry,CBO Building Commissioner 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma:uS - 1. Office: 508-862-4038 _ Fax: 508-790-6230 r Property Owner Must Complete and Sign This Section. If Using A Builder I, , as Owner of the subject property hereby authorize to act on my behalf, in all matters relative to work authorized by this building permit application for: ' V 1 (Address of Job) Signature of Owner Date Print Name If Property Owner is applying for permit,please complete the Homeowners License Exemption Form on the reverse side. - QAVIPFILES\FORMS\building permit forms\EXPRESS.doc Revised 040215 Town of Barnstable Regulatory Services dFj ,r Richard V.Scali,Director Building Division 4 BARNSfAULFF ' Tom Perry,Building Commissioner MASS. 1639. ��� 200 Main Street, Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEOWNER LICENSE EXEMPTION Please Print DATE: JOB LOCATION: number street Village S "HOMEOWNER": CJ1/// name ��✓✓ home phone# c � work phone# . CURRENT MAILING ADDRESS: i� Dc � /— T _�yr.4.✓.csiS /Yl.� D.Z�lJ ity/town; state zip code The current exemption for"homeowners"was extended to include owner-:occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. TI'I DEFINON OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be, a one or two- family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such"homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes, bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection procedure and requi�ements that he/she will comply with said procedures and requirements. Si afore of Homeowner Approval of Building Official . Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control. HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor (see Appendix Q,Rules&'Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require,as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care t amend and adopt such a form/certification for use in your community. Q:\WPFILES\FORMS\building permit forms\EXPRESS.doc 1 Revised 040215 • Yc�s�u r�rgrr�rfia• - - ' [S� ` TrrcrT r mant a $rfr d r s/c nra/ G `r�xrtalP Frrtrr Re Cdr i C 127 e ttS� C --� Amy=agemapinyF _ Type-Of � 3- I ffita[II am a employer wifii ❑ g i s =d I I$egr ' epees{€zt1 andTor �* havdl�ire�the s�- I am sole 7_ ❑ g7 ro sb�p aui haZ*e na employees 0 DemaaimL �rme m agy eu�xTayees=ahav�'rvof3=- To `COMP_incnrat,ra � L $ 4- ElBns�mgaddiiiOn 1 5_ ❑ Wt. am acarparfikimandiis I0-❑ cdrepa�uradddians J-❑I=ahomes&inb aUwort` affirssham�"`�`�� II_[]Pimlbmg MPaim or bdcRiians MySetf[NO WC =e=33p isrrrxs�nrg 1'[ c-IS?,�I(4} mdwehamaD • employees_�a I�-❑'Qf3�r - "rip ffipfin��chersb�;�I amsixltn fIl o�tl��beTas�sh��ffieatva�ers'mmn�tinuPcrTi�' . � tnes uha ids�ii d4:;. `�:�ray aIIr.�=T f�.�ost9�[n�[aCt�s�mtt svlx�east F�d.•�tm � a���t�bazmaststtshe3ran3�tr;".,7�.tthen�affftesu�s-�ssmd.st��che�serant�se5.-ee _ e�Iupets_ Ifth��h-cm�d�h.-ree�I�yte�,meg�stpmaideth�-w�'tamg.p��e� vaa'r �`rrgxlrrp� rhr�isgr id�g t�*orkers'cotuu sr na ra for t$g ptr�Iayesr Belaw is fhepaEq arid3vh sits Tac*+r�+�•-o.C,ompsayl�ame_ .. - Pa E ar'seEf-inp-1 r-Iff- 4 • ' Tn�� �t�;�• CifyfSp:• f#ar� spy �svriass'ta�peus� an paIrtf dec rs an gage{shasr�g fh Pali �¢tEm3�er=a boa Este}: FaRUM to seMsm cuv=age asmqixeduQd mo:er S= 25A ofleLM c- 152 cam lmff iu tac imgasftiqa a.'rzinxiaaI p=z i=of a fix*P.ug to S L5DD Qd anUor one-yearimp as wen as cirI per_m$ie fi=.of a STOP VJGRX ORDHK and a fine of up fa S250-DO a day agar die violater_ �e ffdvised a Cupp gf this may be fi led to C1fbra of Im�igxtioIIs of�DIA fnr**,�n�cams-age - I efaas uadpsr� xss r fhat$fe uvnrcrriaa pravid��ahat*e is true card cunsct 'TT�s rruF Iv not wribrin 9r area,At 5g c ar ffeW by dtp ar ftum&ffic,rTL A uQrFtg trsrle 7lnR: LPoai-d�€�ea�3.$u�'F�n� g,t�f�{£�at��Iz ��IccbicaZ�zec#nr �.P�m� tar Clfh�r General Laws chaptm -152 requires all employers to war s'cue n for t in employr Pmt,Tarfi o tints sbEtodn'an errp&yce is dmfiued as.every pmsaa m fne=Tice of.7anfher under any CDnt-mi t Dfhire, ePress is izIIgjiecL anal orb" , An�T�p� is defined as van mr�viffi 1,pa tammbip,as�c an,caiPol�un or other legal enfiiy,or aay-two or more offfie kamgomg engaged in,aJ� �� `j legal� of a dmcased e�.playe-r,-Cl the rt;ceives ctr trff b=of an m�zat,pattnembip,association or Qther legal misty,m ployrng empIDye� However the ovine r of a dwelFmglZausehavmgnotmDr�than flaee apartm�s anri who resides fficrein,CEC thD Dccugant of the . dwelling house of anothm-whrs emplays persons to do maitmanm,construction,or repair work on such dwelling house or on ffie gtaunds or bul7dmg azrt thereto shaIl not bec=se of iron h effipIDyment be deemed to be an e�plo31 er" MCrI, char I52, §25C(6)also stains ffiat¢every-staff:or local li=nsm.g agency shall withhold fha issaance or renewal of a license or pest to operate a.business or to construct bruZdmgs is the commonwealth for airy applicant Who has not prndizced acceptable eviderrre of coiaphaace coverage regaam3' A ditially,MM chapter 152,§25C(7)states'Nchhmfac commonwealthnor any ofifspoliti-cal subdrvisions shill rm ent=into any ca a±L c for the p=b=aBn ce of pubfic weal until acceptable evidence of compliance with the;,,c . ce rem ==ots of f as chapter have been preserted to fat confracting a_*thority.- Applicants Please fill oat fhe workers'compensation affidavit completely,by ch=king the boxes that apply to yc-sr sltuatnDn and,if necessary, supply Eub-conttacbr(s)name(s), addresses)andphane mTm S)along with they cerancaieCs) of m ssarm=_ T'=ted Liabidmy Companies(LLC)or Lid.Liability Partnerships(LI P)o n o employees othC•i'ban the memb ers or partners,are notreguired to cant'workers' compensation m=rEUCe- If as LLC or LLP does have employees;a policy is required_ Be.advised that this affidavitmay be submitted t i tht Deparlmmmt of Industrial Accidents for conformation ofinsurance Coverage. Also be sure to sign and date the affidavit. The affidavit should be ratr=ed to the city or town that the application for the permit or IiCCEIse is being rcqu.esttd,not the Departnebf of Industrial Accidents. Should you have any quesdnTc o° the Iaw or if you are regr�d to obtaia a workers' coensation pDIicy;please call t$r Departne�atthe number Es rd below. Self insured companies should eater their mp self-ms=nce license number on the appropriate at. City or Town Officials Please be sure inaf the affidk4it_is ctnnpleFE and•prn legibly The Depadmmti�as provided a syare atffie brit m oflne affidavit foryflutD fill out in the event the Office ofla inns has to Contact Yonregasdmg the applicant Please be sm-e;��.in the pemLitl3ieeose number vihicli�be tiled as aref�nce nBmbe� In adcL�iion,an EPplicant . '- .• that must subn�multiple peaiVEcense appEtati ons tit any given year,need only snbm if pne a$tiavit inoie2ling cuaent policy information(ifneressary)and uader'Job Bite Address"the applicant should write'all locations In (city or ' town)."A copy of the affidavit that has been officially stamped or m &rd by the city or town maybe provided in the, applicant as proof that a valid affidavit is on file fur future permits or licenses_ Anew affidavit must be f Ii led otIt each year.Where a home owner or citizen is obtaining a license or permit not related tn'any business or commercial vesture e.a dog lice:use or p�to bam leaves etc.)said person is NOT regolred to complete�affida�Zt The Office of htveslagations would hke to thank you in advance ffiryour eoDperatiDn and should you have any questions, please do not 3 m3hte tc)give tis a call The Del a.M Meaofs adnress,trlephone and faxmmmbez-_ Thy Commaav��,aja ofMassac URR DaniJ=at of Jud&zjaI A _ ... • ' . $cam=I�i�zl� Ted i--6I7-727-4,90-0 Q�±4.66 ur I4' ML4 Z�. . Rw,-4 617-727-774-q Revised 4-24--D7 i,7 [ ] [R325 026 . 001 , ] , LOC] 0255 OCEAN STREET CTY] 07 TDS] 400 KEY] 238200 ----MAILING ADDRESS------- PCA11041 PCS100 YR100 PARENT] 0 ANESTIS, JAMES & JOYCE & MAP] AREA] 69AC JV] 436727 MTG] 0000 BURKE, D & M SP1] SP21 SP31 18215 JUPITER LANDINGS DR UT11 UT21 . 25 SQ FT] 1166 JUPITER FL 33458 AYB11930 EYB11965 OBS] CONST] 0000 LAND 35100 IMP 60600 OTHER 800 ----LEGAL DESCRIPTION---- TRUE MKT 96500 REA CLASSIFIED #LAND 1 35, 100 ASD LND 35100 ASD IMP 60600 ASD OTH 800 #BLDG(S) -CARD-1 1 60, 600 DESCRIPTION TAX YR CURRENT EXEMPT TAXABLE #OTHER FEATURE 1 800 TAX EXEMPT #PL 0000 OCEAN ST HYANNIS RESIDENT' L 96500 96500 96500 #DL LOT 4 OPEN SPACE #RR 1133 0085 COMMERCIAL INDUSTRIAL FM:R325026182 EXEMPTIONS SALE111/87 PRICE] 1 ORB16019/124 AFD] I TE A LAST ACTIVITY] 10/23/95 PCR] Y ,sy R325 026 . 001 • P P R A I S A L D A T 1� KEY 238200 ANESTIS, JAMES & JOYCE & LAND BLD/FEATURES BUILDINGS NUMBER ZN/FL=RB 35, 100 800 60, 600 1 A-COST 96, 500 B-MKT 62, 200 BY 00/ BY ML 6/88 C-INCOME PCA=1041 PCS=00 SIZE= 1166 JUST-VAL 96, 500 LEV=400 CONST-C 0 ----COMPARISON TO CONTROL AREA 69AC -- TREND EXCEEDS STANDARD NEIGHBORHOOD 69AC HYANNIS PARCEL CONTROL AREA TREND STANDARD 101 10 LAND-TYPE 351001 LAND-MEAN +Oo 965001 139993 IMPROVED-MEAN -570-o 250 ] FRONT-FT ] 100 DEPTH/ACRES TABLE 02 140a1 LOCATION-ADJ APPLY-VAL-STAT 1 LNR] LAND LFT/IMP]ADJS/SB/FEAT STR] STRUCTURE ARR]AREA-MEASUREMENTS NOR] NOTES COM] MARKET INC] INCOME PMR] PERMITS GRR] GRAPHIC FUNCTION- [ ] STRUCTURE-CARD NO- [0 0 0] DATA- [ ] XMT [?] R325 026 . 001 ! P E R M I T [ ] ACT*[R] CARD [000] KEY 238200 000000001 PERMIT-NO MO YR TYPE VALUE CK-BY MO YR oCMP NEW/DEMO COMMENT x { �OM~� US �05 OT N fr rev ' RESIDENTIAL PROPERTY MAP NO. LOT NO. FIRE DISTRICT SUMMARY STREET -455y Ocean St. Hyannis k)3 LAND z 325 26 -1 -1 / g BLDGS. 1 C OWNER O�'Geti�Lr .-; i'1 . L:llr �.-,., .(.(c.�,� TOTAL LAND RECORD OF TRANSFER DATE BK PG I.R.S. REMARKS:Lot 1. (8-2 0-90) � ned 9£'S�, pport. or Y TOTAL7, 45 - - _ LAND Anestis, James, . z & Burke, Donald & Melissa ? 4-2-79 2893 302 30 0 ReSubDiv.for '81 BLDGS. TOTAL N RD. 'v e New P1 an,See #325-2 -2 LAND p 3 D BLDGS. TOTAL LAND BLDGS. - TOTAL LAND BLDGS. TOTAL LAND G 2 �OiCO W. �. BLDGS. - i TOTAL LAND BLDGS. INTERIOR INSPECTED:— - �_ TOTAL / LAND DATE: ,7 7� -- - ACREAGE COMPUTATIONS BLDGS. _- ND TYPE # OF ACRES PRICE TOTAL DEPR. VALUE TOTAL HOLISM. / cl LAND CLEARED FRONT c� r� ,Q�. �jj ©J BLDGS. O) TOTAL REAR _. .WOODS&SPROUT FRONT ytS - i / DOO ""DO Od LAND REAR - BLDGS. WASTE FRONT TOTAL REAR LAND BLDGS. O1 TOTAL r� _'�-- %,+ r.,^'� y:'=• �, i,�a_�is LAND BLDGS. O) LOT COMPUTATIONS LAND FACTORS - TOTAL FRONT DEPTH STREET PRICE DEPTH% FRONT FT.PRICE TOTAL DEPR. COR. INF. VALUE HILLY TOWN SEWER LAND ROUGH TOWN WATER BLDGS. HIGH GRAVEL RD. TOTAL LOW DIRT RD. LAND SWAMPY NO RD. BLDGS. rn. ,:m. Blk. WallsA r/ Bsmt. Rec. Room St. Shower Bath p Bsmt. �7� c. Slab Bsmt.Garage ,St. Shower Eat. PURCH. DATE 7 , Walls PURCH. PRICE. lick Walls Attic Ff.&Stairs Toilet Room Roof RENT rune Walls Fin.Attic Two Fixt. Bath I • •!+ ,••rs_ INTERIOR FINISH Lavatory Extra Floors 2 3 Sink / r r x r/ Plaster Water Cie. Extra Attie ,_.XTERIOR WALLS Knotty Pine Water Only / .S -w Aile SidingPI smt. Fin. _ Plywood No Plumbing , .,;le Siding Plasterboard Int.Fin. jShingles TILING Blk. G F P. Bath Fl. Heat u Brk.On Int.Layout Bath Fl.&Wains. Auto Ht.Unit + l� �j '1 • Veneer Int.Cond. Bath Fl. &Walls Fireplace / Brk.On HEATING Toilet Rm.Fl. plumbing •may) P ,d Com. Brk. Hot Air Toilet Rm.Fl. &Wains. Il'` Tiling Steam Toilet Rm. Fl.&Walls y� .nket Ins. Hot Water St.Shower .,I Ins. Af U Air Cond. Tub Area Total Floor Furn. ROOFING COMPUTATIONS ' ph. Shingle Pipeless Furn. S.F. ,.,d Shingle No Heat S.F. Shingle Oil Burner S.F. - ,te Coal Stoker i _ S.F. / /4' S 5/F.•x7. m/ O.� 1N G�2/ �� . Gas S F OUTBUILDINGS " ROOF TYPE Electric S.F. 1 2 3 4 5 6 7 B_ 9 10 1 2 3 4 5 6 7 8 ,9 10 MEASURED ,We Flat Mansard FIREPLACES S.F. Pier Found. Floor G .2 :rnbrel Fireplace Stack Well Found. v 0.H.Door Ci LISTED FLO R)5 Fireplace Sgle.Sdg. Roll Roofing mc. V LIGHTING Dble.Sdg. Shingle Roof m No Elect. Shingle Walls Plumbing DATE rdwood ROOMS Cement Blk. Electric PRICED .ph.Tile Bsmt. 1st TOTAL g 9 Brick Int. Finish agle 2nd 3rd FACTOR REPLACEMENT OCCUPANCY CONSTRUCTION SIZE AREA CLASS AGE REMOD. COND. REPL.c,VAL. Phy.Dep. PHYS. VALUE Funct.Dep. ACTUAL VAL. ,VLG. jam. -. J -` S� I 3r� 07 / 0 3 r .3 0 0 - 4 b !i ,I TOTAL `y U ------------------LU----------------A PROPERTY ADDRESS I I ZONING I DISTRICT CODE SP-DISTS.I DATE PRINTED I CLASS I PCS I NBHD KEY NO. 0255 OCEAN STREET 07 RB 400 07HY 07/09/95 1041 00 69AC R325 026.001 238200 LAND/OTHER FEATURES DESCRIPTION ADJUSTMENT FACTORS ,y UNIT ADJ'D.UNIT A N tS T I S I J A M E S 8 J O Y C E 8i M A P— L—d BylD..e sire Dtmenswo LOC./YR.SPEC.CLASS ADJ. COND. P PRICE PRICE ACRES/UNITS VALUE D,scnpnon cD. FF.D,mlAcres _�, #LAN D 1 35,100 CARDS IN ACCOUNT — L 10 1BLDG_SIT: 1 X .2!B=14C 251 39999.9 140559.98 .25 35100 #8LDG(S)—CARD-1 1 60,600 01 OF 01 A #OTHER FEATURE 1 800 COST —___97637U0— N BATHS 1 .0 U X C= 100 3500.00 3500.O0 1.00 3500 B #PL 0000 OCEAN ST HYANNIS MARKET 62200 D RG1 DETGAR S 12 X 20 193 D= 20 22.3 3_4 240 300 F #DL LOT 4 . INCOME AI #RR 1133 0035 USE APPRAISED VALUE D p I A 96P500 A I PARCEL SUMMARY T AND 35100 A 3LDGS 60 IMPS 600 T 800 M OTAL 96500 F E4 CNST E N DEED REFERENCE Tye, DATE Re d,el R I O R YEAR VALUE Ins; Sale,Priee A T B6k019/124tTFF11/87 A 1 ' SLDGS 61400 Mo. Y, D AND 35100 T 2893/302: :00/00 OTAL 96500 R F BUILDING PERMIT PARCEL SHOWS AS S N—t-, Dale Type A—, #325-026_001_001 LAND LAND—ADJ INC ME ISE SP—BLDS FEATURES BLD—ADJS UNITS ON MAP._ 35100 cl 800 3500 ENTRANCE GAINED cpns, Tma, B n Nprm oos TO 1ST FL ONLY.. Class Base Rate Atll.Rate Age CND Loc %R G Rep, Cost New Ad' Rep, Vatue $,a� He,gM Rooms Rms B„ns I F.�. I Pe�,yr,il FK. I Unns Units Ac e 1 D,Ot Co,d. 102C 000 100 100 62.45- 62.45 30.65 29 66 100 66 91788 60600 1 .3 6 3 1.0 4.0 �Descriptbn R.I. Square Feet Rep(,Cost MKT.INDEX: 1�00 IMP.BY/DATE: ML 6/88 SCALE: 1/00_66 ELEMENTS CODE CONSTRJCTION DEl'AIL S 3AS . 100 62.45 1166 72817 G CU T GP:UU FEP 65 40.59 11.2 4546 *----------34---------* STYLE 10 LD STYLE_ 0.0 0.0 _ __ T B13 15 9.37 . 1166 10925 ! 813 ! ESIGN ADJMT 00 R ! 12 ! EX TER.WA _ CCS ft OOD SHINGLES O.O U ! ! EAT/AC TYPE 39i-A-WP IL-HOT.MATER 0.0 C *5—* NTcR.FTM(fSH 04WY-WALL (f.O T ! ! NTFR:LAYOUT- "T2V-Ef _7N6RMAt U.0 U ! 35 NTER'QllACTY- -92Al'fE-AS`EXTrif --U__0 R ! BASE ! LDVR-STKUC7 02 JOISrt/BEAM( U.0 A W ! ! --- L � E CDU-R-tDYER-- -04ET" "-U.0 p,a�Areas Au.= 1 278 Base= 1166 ' ! ! 00E-TYPF---- -03 IF=ASP-14-SHTNG--M-0 BUILDING DIMENSIONS 30 L ErT R I Z A L OT MER A GY U.-0 S W16 FEP S07 E16 N07 W16 .. ! ! OUTfDATT-UN - -OS 3 TUNE VXCCS ---9TT.9 A BA5 S07 W13 N30 W05 N12 E34 S35 ! ! ------------- --- --------------------- ._ B13 N35 W34 S12 E05 S30 E13 ! *----16---X NEIISHBOR U00 VIVA C--HYANNTS------- 7 E16 813 .. ! 7 7 LAND TOTAL MARKET ! ! FEP ! PARCEL 35100 96500 *---13---*----16---* AREA 17499 VARIANCE +0 +451 STANDARD 25 x i pW � r 3 •4 1 i� :8 4 TOWN OF BARNSTABLE REPOR&PPLEMENTARY/CONTINII.�ON REPORT ' r NAME (LAST, FIRST, MIDDLE) DIVISION /DEPT NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL is ETC. SUBMITTED BY PAGEol 112,2 1 t 3-�-�7 s TOWN OF BARNSTABLE REPORT S LEMENTARY/CONTINUAT REPORT NAME (LAST, FIRST, MIDDLE) \`%il � /V""� -� 4 DIVISION /Harr NOTE DETAILS i OBSERVATIONS-ITEMIZE EVIDENCE, SERIAL SS ETC. ft. SUBMITTED BY PAGE t 1,6 �J L .r.•:::::..;.;. .... :..... �..................... � c� ':•:•:<::>:: B ILDIN ERVI 2---- ::::.::..:............. :.:: .: 325 026.0 :.::<x< <{: OEM mm� iji HADU..: .................:...:.WV . ............ ............................ .......... ... ... >•ANE TI =; LEAN C STREET «: .......:....:.::::.. NIS ................. ::: <<> ZONING MEN 1 ::::..... « ' ` .111 .........................:......................................:..........:::......................................................... ...... LEGAL?????????? I Mill ORION oil ... UNN ii EAR H ....:.:...::... <:>>> s s i r vi r d. j s 1